Unit 6
Chapter 18
NURSING CARE OF CLIENTS WITH PERIPHERAL VASCULAR
DISORDERS
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Causes
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Sympathetic nervous system overstimulation
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Alterations of the renin-angiotensin-aldosterone system
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Chemical mediators of vasomotor tone and blood volume
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Interaction between insulin resistance, hyperinsulinemia and endothelial function
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Risk factors
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Aging
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Race
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Family history of hypertension
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High sodium intake
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Low potassium, calcium, and magnesium intake
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Obesity
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Insulin resistance
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Excess alcohol consumption
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Stress
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Manifestations
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Initially
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Complications
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Medications
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Diuretics
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Beta-adrenergic blockers
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Central acting sympatholytics
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Vasodilators

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ACE inhibitors
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Angiotension II receptor blockers
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Calcium channel blockers
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Nursing diagnoses
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Ineffective health maintenance
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Risk for noncompliance
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Imbalanced nutrition: More than body requirements
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Excess fluid volume
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Nursing Interventions
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Related to a specific underlying cause
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Malignant hypertension
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Rapid elevation of the blood pressure
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Treatment is initiated within 1 hour
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Risk Factors
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Manifestations of hypertensive crisis
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Medications

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Nursing diagnosis-
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Nursing interventions
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Continuous blood pressure monitoring
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Titrating medications to blood pressure readings
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Avoiding rapid blood pressure changes
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Providing calm reassurance to the client and family
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Lymphadenopathy
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Lymphedema
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Lymphangitis
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Treatments for lymphedema
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Nursing diagnoses
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Impaired tissue integrity
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Excess fluid volume
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Disturbed body image
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Nursing Interventions

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Aneurysm
--Abnormal dilation of a blood vessel
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Commonly affect aorta and peripheral arteries
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May also develop in the ventricles
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Form due to weakness of the arterial wall
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Hypertension is major contributing factor
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Risk Factors
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Thoracic aortic aneurysms- treatment
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Aortic Dissection
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A life-threatening condition
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Tear in artery inner layer allows blood to dissect or split the vessel wall
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Treatment
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Nursing diagnoses
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Risk for ineffective tissue perfusion
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Risk for injury
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Anxiety
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Nursing Intervention-

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Peripheral Vascular Disease (PVD)
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Hardening and narrowing of peripheral arteries
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Impairing blood supply to peripheral tissues
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Collateral circulation usually inadequate
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Risk Factors for PVD
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Medications
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Nursing diagnoses
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Ineffective tissue perfusion: peripheral
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Pain
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Impaired skin integrity
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Activity intolerance
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Nursing Interventions-

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Thromboangiitis Obliterans
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Also called
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Inflammation and spasm cause
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Risk Factors
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Surgical treatment
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Sympathectomy
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Arterial bypass graft.
Nursing Diagnosis-
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Nursing Interventions-
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Raynaud’s Disease and Phenomenon
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Episodes of intense vasospasm in the small arteries and arterioles
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Genetic predisposition
Raynaud’s disease
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No identifiable cause
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Blue-white disease
Raynaud’s phenomenon
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Secondary to another disease or condition
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Medications
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Nursing diagnosis
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Nursing Interventions

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Acute Arterial Occlusion
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May occur by
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Risk factors
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Medications
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Nursing diagnoses
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Ineffective tissue perfusion: peripheral
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Anxiety
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Altered protection
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Nursing Intervention
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Venous Thrombosis
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Also known as thrombophlebitis
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Condition in which a blood clot forms on the wall of a vein
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Causes inflammation of the vein
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Some degree of venous blood flow obstruction
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Risk factors for Venous Thrombosis
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Medications
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Nursing diagnoses
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Pain
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Ineffective tissue perfusion: peripheral
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Ineffective protection
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Impaired physical mobility
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Risk for ineffective tissue perfusion: Cardiopulmonary
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Nursing Interventions
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Chronic Venous Insufficiency
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Disorder of inadequate venous return over a prolonged period
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Most common cause is deep vein thrombosis
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Venous stasis occurs, impairing arterial circulation
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Risk factors for chronic venous insufficiency
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Manifestations
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Medications

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Corticosteroids
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Zinc oxide
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Clotrimazole
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Miconazole
– Burrow’s solution
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Nursing diagnoses
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Disturbed body image
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Ineffective health maintenance
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Risk for infection
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Impaired physical mobility
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Impaired skin integrity
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Ineffective tissue perfusion: peripheral
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Nursing Interventions
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Varicose Veins
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Irregular, tortuous veins with incompetent valves
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Commonly found in the lower extremities
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Risk factors
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Treatments
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Nursing diagnoses
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Chronic pain
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Ineffective tissue perfusion: Peripheral
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Risk for impaired skin integrity
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Risk for peripheral neurovascular dysfunction
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Nursing Interventions-
Surgical Interventions
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Indicated for:
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Preoperative Care
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Postoperative Care
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According to surgical procedure performed